PMID- 16962477
OWN - NLM
STAT- MEDLINE
DCOM- 20061024
LR  - 20060911
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 25
IP  - 9
DP  - 2006 Sep
TI  - N-terminal pro-brain natriuretic peptide, kidney disease and outcome in patients 
      with chronic heart failure.
PG  - 1135-41
AB  - BACKGROUND: In patients with chronic heart failure (CHF), N-terminal pro-brain 
      natriuretic peptide (NT-proBNP) provides relevant prognostic information, but its 
      usefulness in the presence of kidney disease has been questioned. METHODS: We 
      prospectively enrolled 142 patients with stable CHF and a wide spectrum of renal 
      function (estimated glomerular filtration rates [eGFRs] ranging from 17.1 to 
      100.3 ml/min/1.73 m2). Chronic kidney disease, defined as eGFR < 60 ml/min/1.73 
      m2, was present in 63 patients (44%). NT-proBNP measurements were carried out on 
      a bench-top analyzer (Elecsys 2010). Cardiac death or urgent cardiac 
      transplantation were considered as a combined study end-point. RESULTS: During a 
      follow-up of 383 +/- 237 days, 19 patients underwent a cardiac event (cardiac 
      death, n = 17; urgent cardiac transplantation, n = 2). By multivariate Cox 
      analysis, including clinical and laboratory variables, NT-proBNP and serum 
      hemoglobin were independent prognostic predictors. In patients with NT-proBNP > 
      1,129 pg/ml, outcome was significantly worse compared to patients with NT-proBNP 
      < 1,129 pg/ml (event-free survival rate 67% vs 94% in those with NT-proBNP < 
      1,129 pg/ml, p = 0.001). By linear regression analysis, NT-proBNP levels were 
      related to New York Heart Association (NYHA) functional class (R = 0.41, p < 
      0.001), and inversely related to eGFR (R = -0.29, p = 0.001) and to left 
      ventricular ejection fraction (R = -0.43, p < 0.001). CONCLUSIONS: In CHF 
      patients with and without kidney disease, NT-proBNP provides independent 
      prognostic information. In such patients, NT-proBNP levels are not only 
      reflective of a reduced clearance (i.e., a lower eGFR) but also of the severity 
      of the underlying structural heart disease.
FAU - Bruch, Christian
AU  - Bruch C
AD  - Department of Cardiology and Angiology, Hospital of the University of Munster, 
      Munster, Germany. bruchc@uni-muenster.de
FAU - Reinecke, Holger
AU  - Reinecke H
FAU - Stypmann, Jorg
AU  - Stypmann J
FAU - Rothenburger, Markus
AU  - Rothenburger M
FAU - Schmid, Christof
AU  - Schmid C
FAU - Breithardt, Gunter
AU  - Breithardt G
FAU - Wichter, Thomas
AU  - Wichter T
FAU - Gradaus, Rainer
AU  - Gradaus R
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20060802
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Output, Low/*blood/mortality/*physiopathology
MH  - Chronic Disease
MH  - Female
MH  - Glomerular Filtration Rate/physiology
MH  - Humans
MH  - Kidney Diseases/*blood/*physiopathology
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Survival Rate
EDAT- 2006/09/12 09:00
MHDA- 2006/10/25 09:00
CRDT- 2006/09/12 09:00
PHST- 2006/03/13 00:00 [received]
PHST- 2006/04/30 00:00 [revised]
PHST- 2006/05/15 00:00 [accepted]
PHST- 2006/09/12 09:00 [pubmed]
PHST- 2006/10/25 09:00 [medline]
PHST- 2006/09/12 09:00 [entrez]
AID - S1053-2498(06)00403-7 [pii]
AID - 10.1016/j.healun.2006.05.006 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2006 Sep;25(9):1135-41. doi: 
      10.1016/j.healun.2006.05.006. Epub 2006 Aug 2.